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AABB 2012

Boston, Massachusetts

Age of Blood Transfused In the United States: Data for 166,208 TransfusionsConclusions: For the hospitals studied, the current RBC supply chain and inventory management systems result in 47% of RBC units being transfused more than 3 weeks and 25% more than 4 weeks after their donation. Modifying the current supply chain to provide “fresher” blood will require substantial practice change and system redesign.

Blood Transfusion and Length of Stay: How Are They Related?Results: LOS was related to Nadir Hgb irrespective of transfusion status. Within each group of Nadir Hgb (except <7 g/dL), patients who received allogeneic blood had longer
LOS than those who did not. Patients who received PAD (n=1179) had both longer LOS (3.50 vs. 3.07 days) and higher allogeneic transfusion rates (27.1% vs.17.3%) than those who did not receive PAD.

Variability in Transfusion Practice – Beyond Cardiac SurgeryMethods: We queried a proprietary blood management business intelligence portal (IMPACT® Online, Haemonetics, Braintree, MA) and identified 9 noncardiac procedures associated with substantial red cell (RBC) transfusions. For each procedure, we determined the mean RBC transfusion and utilization rate for the entire hospital stay as well as the standard deviation (SD) of those rates among the participating hospitals (those that contributed at least 20 patients to each data set).

SABM 2012

Pittsburgh, Pennsylvania

Periodic data review assures sustainability of blood management programsResults: Dramatic reductions in the use of PAD were achieved in each hospital. These improvements were not only sustained but continued during follow up. Similar success and sustainability was seen in the cardiac surgical interventions as reflected in decreased RBC utilization (units/patient including untransfused patients) for patients having coronary artery surgery (CABG).

Two unit dosing leads to excess transfusionMethods:
Using a blood management business intelligence portal (IMPACT® Online, Haemonetics®, Braintree, MA) we determined the hematocrit at discharge of transfused patients who had either unilateral total hip or knee replacements during 2010 or 2011. From a group of 20,758 patients at 15 US hospitals, we removed 105 with incomplete data, 545 without a hematocrit following their last transfusion and 1,194 who received preoperatively donated autologous blood. Of the remaining 18,914, 3,033(16%) received allogeneic RBC.